Statement: From the Front Lines - Single-Payer System is the Sole Solution

January 28, 2009

James Floyd, M.D., Health Researcher, Public Citizen

Public Citizen has joined the Leadership Conference for Guaranteed Health Care because a single-payer national health insurance program is the only viable solution to our health care crisis.

We have a fragmented health care system that is driven by corporate profit and greed. Although private insurers provide coverage for less than two-thirds of Americans, they drive up administrative costs for everyone so that, on average, 30 cents of every health care dollar is spent on administration, much of this wasted. As a result, costs are skyrocketing and 50 million Americans are left without health insurance. Tens of millions more have insurance but are still unable to afford the care they need.

I am a health researcher with Public Citizen and a practicing internist. It is common for my patients to be taking 10 or more medications, some of which are life-sustaining, and for them to require frequent visits with their physicians. With frightening regularity, I see patients who cannot get their prescriptions filled or afford co-payments for office visits.

As a result, many become ill enough to require hospitalization, and some even die. I recall taking care of a veteran who developed nearly fatal kidney failure from an enlarged prostate because he was too poor to afford private coverage but made too much to be covered by Medicaid or the Veterans Health Administration. And I think of a young woman with diabetes who is admitted to the hospital every month with a complication or new infection because she cannot afford the insulin that keeps her out of the hospital. It is sad and unconscionable that cases like this have become commonplace.

During this recession, we can expect even more people to lose their health care coverage, resulting in more missed doctor appointments and unfilled prescriptions. The estimated 20,000 people who die each year because of a lack of health insurance will rise faster than we could have feared. Also, illness due to a lack of health care only feeds the cycle of missed work days and lost jobs, reducing our economic productivity. Our country cannot recover from this recession if we become sicker with every passing year.

The time for delaying meaningful health care reform because of narrow interests is over. We must eliminate private insurance companies as middlemen who divert health care dollars from real care and are responsible for massive administrative waste. Other proposals for health care reform do not address this fundamental problem of waste and will not reduce costs. A single-payer system is the only way to provide everyone with comprehensive care, regardless of their ability to pay, while keeping costs down. It is also the most just one.